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目的探讨胃胃肠间质瘤(GIST)的微创手术治疗体会。方法回顾性分析扬州大学附属泰州市人民医院2008年至2014年收治的行腹腔镜胃楔形切除、内镜定位辅助腹腔镜胃楔形切除(双镜联合切除)、腹腔镜辅助部分和全胃切除及内镜下切除术的62例胃GIST患者的临床资料。结果 62例患者,肿瘤直径2~12 cm;其中行腹腔镜胃楔形切除31例,内镜定位辅助腹腔镜胃楔形切除22例,腔镜辅助远端胃切除3例、近端胃切除2例、全胃切除1例,内镜下切除3例。所有标本病理切缘为阴性,平均手术时间87 min,平均术中出血79 ml,平均胃肠功能恢复时间39 h,术后平均住院时间8.2 d,未发生吻合口瘘、吻合口狭窄、腹腔感染或切口感染等并发症。根据NIH危险度分级标准,中危、高危11例;术后服用伊马替尼,随访2~60个月,未发现肿瘤局部复发和转移病例。结论胃GIST行微创切除创伤小、恢复快,安全可靠,疗效肯定。
Objective To investigate the minimally invasive surgical treatment of gastrointestinal stromal tumors (GIST). Methods A retrospective analysis was performed on the results of laparoscopic gastric wedge resection, endoscopic laparoscopic wedge resection (double mirror combined resection), laparoscopic assisted partial gastrectomy and total gastrectomy in Taizhou People’s Hospital Affiliated to Yangzhou University from 2008 to 2014 Endoscopic resection of 62 cases of gastric GIST in patients with clinical data. Results Twenty-two patients had a tumor size of 2 to 12 cm. Among them, 31 patients underwent laparoscopic gastric wedge resection, 22 assisted by endoscopic laparoscopic wedge resection, 3 assisted distal gastrectomy by endoscopy, and 2 proximal gastrectomy , Total gastrectomy in 1 case, endoscopic resection in 3 cases. The pathology margin of all the specimens was negative. The average operation time was 87 min. The mean intraoperative bleeding was 79 ml. The average recovery time of gastrointestinal function was 39 h. The average postoperative hospital stay was 8.2 days. Anastomotic fistula, anastomotic stenosis and abdominal infection Or incision infection and other complications. According to the NIH risk classification standard, 11 cases were at medium risk and high risk. After taking imatinib, the patients were followed up for 2 ~ 60 months. No local tumor recurrence and metastasis were found. Conclusion GIST minimally invasive gastric resection trauma, fast recovery, safe, reliable, positive effect.